Revenue NSW

Application for waiver of quarantine fees

Instructions:

If all sections are not completed, your application cannot be processed.

Providing a false or deliberately misleading statement may lead to prosecution under Section 307A of the Crimes Act 1900.

Please complete this form to apply for a waiver of quarantine fees.

Primary traveller details

Please provide contact details of the primary traveller only.

Primary address in Australia
Please provide the address where you will reside after your quarantine.
Permanent address overseas (if applicable)

Additional travellers details

 
Full name:
Date of birth:
Passport number:
Traveller 2
Traveller 3
Traveller 4


Traveller 5


Traveller 6


Traveller 7


Traveller 8


 

Supporting documentation

You need to attach the following evidence: copy of proof of ID, purchase receipt and booking confirmation for each traveller.
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Is evidence attached for each traveller?:

Privacy statement

Information collected from you for the purpose stated on this form may be provided to third parties with your consent or as required or permitted by law. Revenue NSW will correct or update your personal information at your request. Read more about privacy at www.revenue.nsw.gov.au

Declaration

Date: 30/11/2020

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